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Effect of Non-surgical Periodontal Treatment and C-reactive Protein Levels in Hemodialysis Patients

Not Applicable
Conditions
Chronic Kidney Disease Stage 5
Periodontitis
Interventions
Procedure: postponed treatment
Procedure: immediate treatment
Registration Number
NCT04262011
Lead Sponsor
Universidade Federal de Santa Maria
Brief Summary

The presence of periodontitis has been hypothesized as a risk factor for several systemic outcomes, including chronic kidney disease (CKD). Therefore, the aim of this study is to evaluate the impact of non-surgical periodontal treatment on CRP levels and quality of life of patients with chronic kidney disease undergoing hemodialysis (HD) in Santa Maria-RS.

Detailed Description

C-reactive protein (CRP) has been identified as a possible mediator of the association between periodontitis and various systemic diseases. The presence of periodontitis has been hypothesized as a risk factor for several systemic outcomes, including chronic kidney disease (CKD). Therefore, the aim of this study is to evaluate the impact of non-surgical periodontal treatment on CRP levels and quality of life of patients with chronic kidney disease undergoing hemodialysis (HD) in Santa Maria-RS. A total of 88 patients with severe periodontitis who are on HD therapy will be included in this study. At baseline, periodontal, radiographic, blood test, and quality-of-life questionnaire will be assessed for all patients, after which severe periodontitis will be defined according to the American Association of Periodontology and European Federation of Periodontology. The 88 patients with periodontal disease will be randomized and divided into two groups. One group will receive full mouth non-surgical periodontal treatment (TPNC) and a late treatment group that will receive TPNC only at the end of the study. All patients will receive follow-up of periodontal parameters and blood collection for initial CRP assessment at 3 and 6 months after treatment. Outcome evaluators will be blind to the group the patient belongs to. Patients in the immediate treatment group will receive follow-up oral hygiene instructions and use 0.12% chlorhexidine mouthwash during the first week after treatment.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
88
Inclusion Criteria
  • Having been diagnosed with chronic kidney disease (CKD) for at least 90 days.
  • Have at least 8 teeth in the mouth.
  • For the patient to be classified as having periodontal disease, he must have at least two nonadjacent sites with insertion loss of 3mm or more and two nonadjacent sites with probing depth of 4mm or more.
Exclusion Criteria

Ineligible individuals were characterized by exhibiting one of the following conditions:

  • Patients diagnosed with malignant neoplasia;
  • Patients diagnosed with carriers of the HIV virus;
  • Pregnant or lactating women;
  • Patients with absence of all dental elements (total edentulous);
  • Patients undergoing orthodontic treatment;
  • Patients who have received periodontal treatment in the last 6 months.
  • Patients with active infection (other than periodontitis) who require antibiotic prophylaxis;

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
postponed treatmentpostponed treatmentAfter randomized patients will be allocated to this group, they will wait for the follow-up of the study to receive delayed treatment.
immediate treatmentimmediate treatmentAfter randomization, patients who are allocated to the immediate treatment group will receive treatment.
Primary Outcome Measures
NameTimeMethod
effect of periodontal treatment on levels of systemic inflammatory markersbaseline changes by 6 months follow-up

To evaluate the impacts of periodontal treatment on the levels of systemic inflammatory markers such as C-reactive protein, albumin and transferrin saturation. The patients will be submitted to the collection of blood sample in the baseline, 3 and 6 months to obtain the clinical variables.

Secondary Outcome Measures
NameTimeMethod
effect of periodontal treatment on overall quality of life and related to kidney diseasebaseline changes by 6 months follow-up

o assess the impacts of periodontal treatment on overall quality of life and oral health that will be assessed using the questionnaire Kidney Disease Quality of Life Short Form (KDQOL-SF) (80 items). This scale ranges from 0 to 100, higher values show a better quality of life.

effect of periodontal treatment on overall quality of lifebaseline changes by 6 months follow-up

To assess the impacts of periodontal treatment on overall quality of life and oral health that will be assessed using the questionnaire The Short-Form Health Survey (SF-36) (36 items). In this questionnaires, the higher the score, the worse the quality of life is considered.

effect of periodontal treatment on psychological condition in patients with chronic kidney disease undergoing hemodialysisbaseline changes by 6 months follow-up

ndividuals' psychological condition will be assessed using the Depression - Anxiety - Stress Scale 21 (DASS 21) (21 items).The highest grades in each scale correspond to more negative affective states.

effect of periodontal treatment on psychological conditionbaseline changes by 6 months follow-up

Individuals' psychological condition will be assessed using the sense of coherence (SOC 13) which proposes to explain successful strategies to cope with stress. For the final score calculation, the items are summed and the result can vary from 13 to 65, where higher scores represent SOC. The the greater the result, the greater the coping capacity.

effect of periodontal treatment on oral health-related quality of lifebaseline changes by 6 months follow-up

To assess the impacts of periodontal treatment on overall quality of life and oral health that will be assessed using the questionnaire Oral Health Impact Profile (OHIP14) (14 items), in this questionnaire the higher the score, the worse the quality of life is considered.

Trial Locations

Locations (1)

Fabricio Batistin Zanatta

🇧🇷

Santa Maria, Rua Floriano Peixoto--, Brazil

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